The combination of chlorpheniramine, guaifenesin, hydrocodone, and pseudoephedrine is used to treat sinus congestion, runny nose, sneezing, itching, watery eyes, cough, and chest congestion caused by allergies, upper respiratory infections, or the common cold.

This medication will not treat a cough that is caused by smoking, asthma, or emphysema.

Chlorpheniramine, guaifenesin, hydrocodone, and pseudoephedrine may also be used for purposes not listed in this medication guide.

What is the most important information I should know about Z-Tuss 2 (chlorpheniramine, guaifenesin, hydrocodone, and pseudoephedrine)?

Do not use this medication if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take a cough and cold medicine before the MAO inhibitor has cleared from your body.

Hydrocodone may be habit-forming and should be used only by the person it was prescribed for. Never share this medication with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it.

Do not give this medication to a child younger than 6 years old. Always ask a doctor before giving a cough or cold medicine to a child. Death can occur from the misuse of cough and cold medicines in very young children.

Ask a doctor or pharmacist before using any other cough, cold, allergy, or sleep medicine. Chlorpheniramine, guaifenesin, and pseudoephedrine are contained in many combination medicines. Taking certain products together can cause you to get too much of a certain drug. Check the label to see if a medicine contains an antihistamine, decongestant, or expectorant.

What should I discuss with my healthcare provider before taking Z-Tuss 2 (chlorpheniramine, guaifenesin, hydrocodone, and pseudoephedrine)?

Do not use a cough or cold medicine if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take cough or cold medicine before the MAO inhibitor has cleared from your body.

To make sure you can safely take this medication, tell your doctor if you have any of these other conditions:

heart disease or high blood pressure;

asthma, COPD, sleep apnea, or other breathing disorders;

diabetes;

glaucoma;

a thyroid disorder;

epilepsy or other seizure disorder;

kidney or liver disease;

enlarged prostate or urination problems;

a stomach or intestinal disorder;

a history of head injury or brain tumor;

Addison's disease or other adrenal gland disorders; or

a history of drug or alcohol addiction.

FDA pregnancy category C. It is not known whether this medication will harm an unborn baby. Hydrocodone may cause addiction or withdrawal symptoms in a newborn if the mother takes the medication during pregnancy. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

This medication may pass into breast milk and could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Hydrocodone may be habit-forming and should be used only by the person it was prescribed for. Never share this medication with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it.

Older adults may be more likely to have side effects from this medication.

How should I take Z-Tuss 2 (chlorpheniramine, guaifenesin, hydrocodone, and pseudoephedrine)?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. Cough or cold medicine is usually taken for only a short time until your symptoms clear up.

Do not give this medication to a child younger than 6 years old. Always ask a doctor before giving a cough or cold medicine to a child. Death can occur from the misuse of cough and cold medicines in very young children.

Take this medication with food or milk if it upsets your stomach.

Measure liquid medicine with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

Drink plenty of water or other fluids to help loosen congestion and prevent dry mouth or throat.

Talk with your doctor if your symptoms do not improve after 7 days of treatment, or if you have a fever with a headache, cough, or skin rash.

If you need surgery, tell the surgeon ahead of time if you have taken a cold medicine within the past few days.

This medication can cause you to have unusual results with allergy skin tests. Tell any doctor who treats you that you are taking an antihistamine.

Store at room temperature, away from heat, light, and moisture.

Keep track of the amount of medicine used from each new bottle. Hydrocodone is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

What happens if I miss a dose?

Since cough or cold medicine is usually taken only as needed, you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of hydrocodone can be fatal.

What should I avoid while taking Z-Tuss 2 (chlorpheniramine, guaifenesin, hydrocodone, and pseudoephedrine)?

This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Drinking alcohol can increase certain side effects of chlorpheniramine, guaifenesin, or hydrocodone.

Ask a doctor or pharmacist before using any other cough, cold, allergy, or sleep medicine. Chlorpheniramine, guaifenesin, and pseudoephedrine are contained in many combination medicines. Taking certain products together can cause you to get too much of a certain drug. Check the label to see if a medicine contains an antihistamine, decongestant, or expectorant.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Z-Tuss 2 (chlorpheniramine, guaifenesin, hydrocodone, and pseudoephedrine)?

Before taking this medication, tell your doctor if you regularly use other medicines that make you sleepy (such as narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety). They can add to sleepiness caused by chlorpheniramine, guaifenesin, or hydrocodone.

Tell your doctor about all other medicines you use, especially:

sibutramine (Meridia);

memantine (Namenda);

methyldopa (Aldomet);

reserpine;

an antidepressant such as amitriptyline (Elavil), clomipramine (Anafranil), imipramine (Janimine, Tofranil), and others; or

This list is not complete and other drugs may interact with chlorpheniramine, guaifenesin, hydrocodone, and pseudoephedrine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Related treatment guides

Where can I get more information?

Your pharmacist can provide more information about chlorpheniramine, guaifenesin, hydrocodone, and pseudoephedrine.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.